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    Become a part of our caring community and help us put health first Humana is seeking a Provider Data Management and Contract Load Professional to support the Wisconsin Medicaid market. This position performs data maintenance for Provider Data Management System and supports various functions within the WI Medicaid Market for all lines of business (Medicare DSNP, Medicaid, and Long term Care), including but not necessarily limited to supporting Provider Network Development and Credentialing. Maintains accurate, up to date provider data in the Provider Data Management System (PDMS).Works in collaboration with other staff to ensure that all provider updates (adds, changes, delete) requests are researched, analyzed, responded to, and completed in an accurate and timely manner.Creates Provider records in the PDMS from received applications.Maintains standards for database integrity and quality assurance.Outreach to practitioners on unreturned applications.Updates practitioner rosters within Provider Data Management System for delegated credentialing agreements. Generates recredentialing applications and conducts follow up with organizational providers on unreturned applications. Enters provider demographic information for Prior Authorization requests within the PDMS.Provides feedback to reduce errors and improve processes and performance; coordinates corrective activities.Works collaboratively with other departments regarding database improvements and updates. Participates in the preparation required for regulatory and internal reporting and the Provider Directory.Represents the department on pertinent internal committees and appropriate meetings.Maintains and responds to department e-mail inboxes.Generates monthly ongoing monitoring reports identifying licensure and certification renewals and performs outreach to providers and organizations ensuring licensure or certification has been renewed. Assists with ad hoc projects. Use your skills to make an impact Required Qualifications Associate degree and 1 or more years of experience in a business or health care environment working with provider files or the collection and coordination of practitioner data OR 2 years of the same experience.Proficiency with computer software programs such as Microsoft Excel, Word and ability to understand and learn new information systems and software programs.Experience interacting effectively with healthcare providers. Preferred Qualifications Prior work experience and knowledge of Long Term Care, Medical, Behavioral Health, and Ancillary providers.Bachelor’s degree. Additional Information Workstyle: Home. Home workstyle is defined as remote but will use Humana office space on an as needed basis for collaboration and other face-to-face needs. Typical Work days/hours: must be available Monday – Friday, 8:00 am – 5:00 pm Central Standard Time (CST) WAH Internet Requirements To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.Satellite, cellular and microwave connection can be used only if approved by leadership.Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Benefits Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including: Health benefits effective day 1Paid time off, holidays, volunteer time and jury duty payRecognition pay401(k) retirement savings plan with employer matchTuition assistanceScholarships for eligible dependentsParental and caregiver leaveEmployee charity matching programNetwork Resource Groups (NRGs)Career development opportunities HireVue As part of our hiring process for this opportunity, we will be using an interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $44,200 - $60,900 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
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    Become a part of our caring community and help us put health first Humana is seeking a Data and Reporting Professional to support the Wisconsin Medicaid market. The Data and Reporting Professional generates ad hoc reports and regular datasets or report information for end-users using system tools and database or data warehouse queries and scripts. The Data and Reporting Professional’s work assignments are often straightforward and of moderate complexity. Humana’s Wisconsin Medicaid Data and Reporting Professional: Integrates data from multiple sources to produce requested or required data elements. Programs and maintains report forms and formats, information dashboards, data generators, canned reports and other end-user information portals or resources. May create specifications for reports based on business requests. Provides analytical support during provider contract negotiation process. Supports negotiation and acts as a consultant in efforts to establish market competitiveness and ensure contract compliance. Assists contracting staff in building tools that model rates. Organizes and performs analytical review of opportunities with provider networks. Utilizes research and decision-making tools to analyze effectiveness of provider network performance through financial modeling, network accessibility and evaluates outcomes compared to expectations.Plans and evaluates current network performance to determine effectiveness and assist in development and implementation of system enhancements by helping to define and update business requirements to ensure the organization’s competitive advantage.Supports network adequacy analysis and network performance. Responsible for retrieving, interpreting, and analyzing data to drive key business decisions and actions, measure program efficacy and contribute to strategic direction.Analyzes contracted rates to assist with determining appropriate rates for provider contracts.Works on various projects related to the analysis of claims, clinical and financial data, with a focus on improvement of financial and/or clinical outcomes.Gathers data from multiple sources and develops necessary analytic data result sets to enable accurate and robust quantitative analyses. Use your skills to make an impact Required Qualifications Bachelor's degree2 years of technical experience in data reporting.Comprehensive knowledge of Microsoft Office Applications - Word, Excel, and PowerPoint.1 or more years of experience in Microsoft SQL, SAS and other data systems. Preferred Qualifications Experience with Power BI or other data visualization software.Experience in managed care or health care sector.Prior experience working in a system analytics and/or data warehousing environment. Additional Information Workstyle: Home. Home workstyle is defined as remote but will use Humana office space on an as needed basis for collaboration and other face-to-face needs. Typical Work days/hours: must be available Monday – Friday, 8:00 am – 5:00 pm Central Standard Time (CST) WAH Internet Requirements To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.Satellite, cellular and microwave connection can be used only if approved by leadership.Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Benefits Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including: Health benefits effective day 1Paid time off, holidays, volunteer time and jury duty payRecognition pay401(k) retirement savings plan with employer matchTuition assistanceScholarships for eligible dependentsParental and caregiver leaveEmployee charity matching programNetwork Resource Groups (NRGs)Career development opportunities HireVue As part of our hiring process for this opportunity, we will be using an interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $48,800 - $67,400 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
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    Become a part of our caring community and help us put health first The Senior Provider Engagement Professional develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within the contracted working relationship with the health plan. The Senior Provider Engagement Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Provider Engagement Professional represents the scope of health plan/provider relationship across such areas as financial performance, incentive programs, quality and clinical management, population health, data sharing, connectivity, documentation and coding, HEDIS and STARs performance, operational improvements and other areas as they relate to provider performance, member experience, market growth, provider experience and operational excellence. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. Use your skills to make an impact Required Qualifications Bachelor's Degree5 or more years of Health care or managed care with Provider Contracting, Network Management or Provider Relations experienceProven planning, preparation and presenting skills, with established knowledge of reimbursement and bonus methodologiesDemonstrated ability to manage multiple projects and meet deadlinesMust be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications Master's DegreeProficiency in analyzing and interpreting financial trends for health care costs, administrative expenses and quality/bonus performanceComprehensive knowledge of Medicare policies, processes and procedures Additional Information Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $63,400 - $87,400 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
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    Become a part of our caring community and help us put health first You have the unique opportunity to join our newly established Integrated Health technology team and help enable seamless delivery of health and care services to the customer across their journey through the ecosystem. Integrated Health will continue to bring the CenterWell assets closer together leveraging patient experience initiatives as a core driver to developing cross-asset capabilities and leveraging data in new ways. If this type of work and vision resonates with you, we would like to talk to you! The Lead Application Architect designs and develops IT applications architecture solutions to business problems in alignment with the enterprise architecture direction and standards. The Lead Application Architect works on problems of diverse scope and complexity ranging from moderate to substantial. The Lead Application Architect performs technical planning, architecture development and modification of specifications. Develops specifications for new products/services, applications, and service offerings. Assesses the compatibility and integration of products/services proposed as standards to ensure an integrated architecture across interdependent applications. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, works under minimal supervision, and uses independent judgment requiring analysis of variable factors and determining the best course of action. Key Responsibilities Collaborate effectively across multiple IT teams, external strategic vendors, and a broad group of user stakeholder groups to define and advance Integrated Health architecture and technology strategy Ensure Integrated Health application architecture aligns with the broader CenterWell Solution Architecture and North Star Architecture Partner with multiple development areas to advance modernization and cloud transformation Lead development and execution of departmental strategic plans and objectives including budget, resiliency, productivity, and other operational priorities Innovate continuous process improvement Required Qualifications Bachelor's degree in computer science, Information Technology or related field 8 or more years' experience as a senior developer in large IT projects Strong experience with cloud platforms (AWS, Azure, Google Cloud) Proficient in programming languages (such as JavaScript, TypeScript, Python, Java) Experience with front-end frameworks (React, Angular, or Vue.js) and backend technologies (Node.js, Express) Knowledge of RESTful APIs, microservices architecture and serverless computing Prior project lead experience Must be passionate about contributing to an organization focused on continuously improving consumer experiences. Strong oral and written communication skills Preferred Qualifications Proficiency in GraphQL schema design and implementation Data Engineering experience designing and implementing data pipelines, data lakes, and data warehouses to support large-scale data processing and analytics Certifications in cloud technologies (i.e. AWS Certified Solution Architect, Azure Solutions Architect, Google Cloud Professional Architect) Experience with CI/CD pipelines and DevOps practices Familiarity with containerization technologies (Docker, Kubernetes) Use your skills to make an impact Work-At-Home Requirements WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense. A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required. Satellite and Wireless Internet service is NOT allowed for this role. A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $126,800 - $174,500 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
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    Become a part of our caring community and help us put health first The Specialty Retention Executive is responsible for retaining and growing membership within existing 2 – 99 Specialty accounts and for partnering with brokers and agents to manage business relationships with client accounts. Humana is seeking a dedicated, detail-oriented, and responsible Specialty Retention Executive who is seeking an opportunity for growth in a progressive organization. The Specialty Retention Executive is responsible for retaining and growing membership within existing 2 – 99 Specialty accounts and for partnering with brokers and agents to manage business relationships with client accounts. The Specialty Retention Executive work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Responsibilities Include: Oversees customer account management for existing 2 – 99 ancillary accounts, including negotiating contracts and agreements.Builds relationships with brokers and agents.Responsible for achieving retention sales goals and add on sales goals for defined book of business.Develops and oversees customer retention campaigns.Product Lines: Dental, Vision, LifeLiaison between assigned clients and Humana internal areas for escalated issues.May represent Humana at community events, associations and industry organizations.Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas.Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Use your skills to make an impact Required Qualifications: 2+ years’ experience selling or retaining within the employer group insurance environment.Understanding of employer procurement processClient management experienceBusiness and Financial AcumenDevelops positive, collaborative client relationships.Active life and health license or ability to obtain within 30 days of hire. Preferred Qualifications: Strong communicator- written, verbal and presentation skills Additional Information Work at Home/Remote Requirements · WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense. · A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required. · Satellite and Wireless Internet service is NOT allowed for this role. · A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information #GroupBenefits Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $47,300 - $65,000 per year This job is eligible for a commission incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
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    Become a part of our caring community and help us put health first Revolutionize observability as our Principal Observability Enterprise Architect. Establish strategies that impacts the entire organization, adopt innovative solutions, and promote a culture that values data analysis. Collaborate cross-functionally, bridging technology and business. Drive innovation, automation, and continuous improvement. Maximize your potential and provide excellent user experiences by closely observing and comprehending all aspects of your operations. Principal Enterprise Architect, Observability is a pivotal role in leading the technology transformation efforts focused on defining the architecture, standards, and governance for observability across the enterprise. Use your skills to make an impact Responsibilities: Advance the observability maturity journey across the enterprise in an effort to accelerate business outcomes driven practice.Partner with product and engineering teams to develop long-term product strategies and business cases.Adept at synthesizing a variety of technologies and capabilities into high quality products and applications that support business driven outcomes.Define enterprise standards, develop and enforce governance controls for Observability.Lead and collaborate on developing reference implementations for various observability capabilities.Provide best practices guidance for approved observability products.Lead and coach others towards enablement of contemporary engineering and agile practicesDrive improvement in the velocity, scale, and sophistication of engineering solutions.Articulate and evangelize Enterprise Observability standards Required Qualifications BS in Computer Science, Electrical Engineering, Information Systems, or a similar field required8 years of experience in engineering and architecture roles at leading-edge companiesExperience with observability, monitoring and logging products (such as Dynatrace, Splunk, Sumologic, Solarwinds, Thousand Eyes, Datadog, New Relic, Grafana etc.)Familiarity with common industry monitoring frameworks like Four Golden Signals, LETS, DORA, MTTx, etc.Experience with open standards (such as OpenTelemetry, StatsD, etc.)Experience with event management products (such as Kafka, ServiceNow ITOM, Big Panda, Splunk ITSI)Experience defining technology standards and building frameworks for adoption and governanceExperience with cloud technologies such as Amazon Web Services, Google Cloud or Microsoft AzureExperience with multi-cloud environments, cloud services, and platform software Preferred Qualifications Demonstrated ability to work collaboratively and building-trusting relationships with stake holdersExperience working with mission critical systemsAbility to apply the principles of analytical and critical thinking skills and other professional practices to diagnose or define problems, collect data and solve abstract problems with widespread organizational impactExperience working in a team-oriented, collaborative and agile environmentHighly self-motivated and directed, with keen attention to detailProven analytical and problem-solving abilitiesAbility to present ideas in user-friendly languageMS or higher in an engineering discipline Additional Information To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested Satellite, cellular and microwave connection can be used only if approved by leadership Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $153,500 - $211,300 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
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    Become a part of our caring community and help us put health first The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Senior Provider Contracting Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Provider Contracting Professional will be accountable to: Communicate effectively and act as a strategic intermediary between the Markets (multiple levels of leadership) and the Clinical Contracting Support Team with the Medicare MarketsCollaborate with Market contracting organizations to identify opportunities for clinical solution implementations; engage the correct SMEs in appropriate dialoguesPartner directly with Clinical and non-Clinical teams from across the organization leadership on the execution of the above activities, as well as in the identification of potential new opportunitiesAssist in the creation of scalable, repeatable, compliant, and standardized implementations of UM ProcessesAssist in the development, iteration, launch and utilization of tools/tracking mechanismsAssist in the identification, creation, value assessment, compliant clinical programs aimed at reducing provider abrasion instances without having to agree to contract concessions termsProvide clinical data reporting for various contract themes and financial impacts to the enterprise.Deliver on a wide range of strategic and tactical activities, including contracting/business development, capability definition and advancement, organizational level strategy, market level opportunities, and partnership on related activities as part of a matrix environmentConvert strategy/tactical priorities into business cases and initiatives while prioritizing timelines and ensuring consensus and executionUnderstand department, segment, and organizational strategy and operating objectives, including their linkages to related areas.Make decisions regarding own work methods, occasionally in ambiguous situations, and require minimal directionFollows established CMS, Humana Policy guidelines, and compliance proceduresResponsibilities will include, but not be limited to the following: Collaborate with Markets, National Provider, and Interoperability teams to drive electronic connectivity and to support clinical processes and alternatives to ALC Alternative Level of Care (ALC) Front End Review (FER) Exclusions, and Independent Review Organization(IRO) language concessionsGuide or consult to optimal performance of clinical/quality metricsDrive clinical solutions to solve for provider abrasion (non-contractual solutions, UM clinical levers, discharge planning, etc.)Implement, manage, and support contractual Utilization Management & other clinical operations Use your skills to make an impact Required Qualifications Bachelor’s degree in professional or healthcare related fieldFive (5) plus years of experience in clinical areas such as: Utilization/Case Management, Claims Resolution, Contract/Market Management, and/or Healthcare AdministrationExperience working as a Subject Matter Expert/Mentor, manager, or strategy leadStrong understanding of CMS Policy & Humana Clinical Policy and ProceduresUnderstanding of economic, financial, and clinical operational conceptsExcellent written and verbal communication skillsAbility to manage multiple priorities in a fast-paced environmentProficiency in MS Office applications Preferred Qualifications Registered Nurse- Licensed as Individual state or multi-state licensure (MSL)Master’s degree in business, Finance or other related field2 - 5 years of experience in UM related to managed care contracts with physician, hospital and/or other UM Clinical programsProficiency in analyzing, understanding, and communicating impact of contract terms or payment structures and reimbursement rates to providersDemonstrate passion about contributing to an organization focused on continuously improving consumer experiences Work-At-Home Requirements To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggestedSatellite, cellular and microwave connection can be used only if approved by leadershipAssociates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $76,800 - $105,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
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    Become a part of our caring community and help us put health first The Associate Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial, and market trends to forecast the organization's short, medium and long-term financial and competitive position. The Associate Actuary, Analytics/Forecasting work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Associate Actuary, Analytics/Forecasting ensures data integrity by developing and executing necessary processes and controls around the flow of data. Collaborates with stakeholders to understand business needs/issues, troubleshoots problems, conducts root cause analysis, and develops cost effective resolutions for data anomalies. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. Use your skills to make an impact Required Qualifications Bachelor's DegreeAssociate of Society of Actuaries (ASA) designationMeets eligibility requirements for Humana's Actuarial Professional Development Program (APDP)MAAAStrong communication skillsSuccessful completion of at least 3 actuarial examsMust be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications Additional Information Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $104,800 - $144,300 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
    • Full Time
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    Become a part of our caring community and help us put health first At Humana, we put the needs of seniors at the forefront of everything we do. The Primary Care Organization is Humana’s senior-focused healthcare provider. Our national primary care centers provide value-based care and represent more than 250 physician practices, 450 clinicians, and 250,000 patients across 18+ markets. The Primary Care Organization (PCO) is in the midst of significant growth. As a Product Marketer on the Local Acquisition Strategy team you will be an important part of the Marketing team and vital to the success of the PCO. We’re looking for a talented marketer who will play a key role in developing local marketing strategies that deliver growth and build the CenterWell and Conviva brands. This is a nationwide remote role. What you’ll do… Reporting to a Lead of the Local Acquisition Strategy team, you will be responsible for supporting the cross-division efforts of the local acquisition strategy team and will serve as a critical conduit to the integrated marketing team and select business partners. This includes the development of strategic resources and reports deployed across markets to build trust and confidence in acquisition marketing. You’ll make an impact as you… Lead the creation of comprehensive and scalable resources aimed at empowering our market partners with a deep understanding and confidence in our acquisition marketing strategies Collaborate closely with the acquisition pod to provide market partners with clear visibility into the creative and media components of upcoming campaigns in their respective markets Support divisional marketers in analyzing and compiling monthly performance reports, enabling our market partners to gauge progress towards goals and marketing impact effectively Serve as a communicator across markets to support the divisional team in socializing acquisition marketing plans, addressing business partner inquiries and supporting special projects Act as a liaison between the acquisition pod and local acquisition strategy teams, gathering market-level inputs to inform quarterly plan development You’ll sweep us off our feet if… You are a polished communicator with the ability to leverage data and information in a clear and concise fashion. You are passionate about not just sharing data but telling a story through meaningful insights You have strong experience working in traditional and emerging marketing channels, including TV, search, digital, social You thrive when working fast, playing well with others, and conquering diverse challenges every day You are a self-starter. You get things done, big or small You are motivated by goals and metrics – and strive to exceed them Ambiguity and setbacks don’t faze you – you thrive in complexity and are ever optimistic Use your skills to make an impact Required Qualifications Bachelor’s degree 2+ years of business, marketing strategy, digital marketing and media marketing experience Positive track record of driving customer engagement with new products, services, and/or experiences Data-driven marketer with an ability to leverage data and insights and translate them into winning marketing strategies Deep empathy for the customer and ability to translate complexities into simple, comprehensible communications Persuasive storyteller who has demonstrated the ability to communicate effectively with senior leaders; executive presence Expert knowledge and use of marketing frameworks Strategically oriented, critical thinker, resourceful, influential, problem solver Highly collaborative mindset and excellent relationship-building skills, including the ability to engage many diverse stakeholders and SMEs, and win their co-ownership in outcomes Strong bias for results, self-starter with strong organizational skills, who is thorough and demonstrates a lot of initiative and follow-through. Preferred Qualifications Experience working in the health care industry Experience in performance marketing A great sense of humor Additional Information To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested Satellite, cellular and microwave connection can be used only if approved by leadership Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including: Health benefits effective day 1 Paid time off, holidays, volunteer time and jury duty pay Recognition pay 401(k) retirement savings plan with employer match Tuition assistance Scholarships for eligible dependents Parental and caregiver leave Employee charity matching program Network Resource Groups (NRGs) Career development opportunities Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $63,400 - $87,400 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
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    Become a part of our caring community and help us put health first The UM Administration Coordinator 2 provides clerical support for the department. We are the beginning, middle and end of processes for utilization management. This role partners with leadership, Medical Directors, Nurses and with other team members. Achieve your best at Humana. Join Us! The UM Administration Coordinator 2 provides non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members. Key Responsibilities: Attaching faxes for chart reviews for the nursing team Answering departmental phones as assigned Make outbound calls to engage providers to verify clinical information/discharge date and admission status Document calls and attach clinical information received Request clinical information from providers/facilities Create and send out written correspondence Ability to multitask and prioritize Creation and distribution of determination letters Collaborate with multiple roles/departments/providers/team members Use your skills to make an impact Required Qualifications 1 or more years’ experience working in an administrative support capacity in the healthcare industry Prior professional experience of Microsoft Word, Outlook and Excel with the ability to type and enter data accurately, as well as the ability to quickly learn new systems (proficient to advanced) Prior experience in a metric driven environment Preferred Qualifications Proficient utilizing electronic medical record and documentation programs Proficient and/or experience with medical terminology and/or ICD-10 codes Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization Additional Information Hours for this role are: Monday – Friday, 8-hour shift will fall between the hours of 7:00am-7:00pm EST and a Saturday rotation may be required based on business needs As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. Work at Home / Internet Statement To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested Satellite, cellular and microwave connection can be used only if approved by leadership Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Alert: Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $37,200 - $51,200 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
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    Become a part of our caring community and help us put health first Humana’s Group Medicare Marketing team is looking for an experienced and passionate Senior Product Marketer, Group Medicare Marketing Strategy to join working remote anywhere in the US. In this role, you will plan, develop and execute marketing strategies and campaigns to deepen broker, consultant and plan sponsor awareness of and engagement with Humana and its Group Medicare Advantage products and services, leveraging competitive intelligence. You will have two, primary areas of focus – supporting the development of strategic marketing plans and developing and activating high-visibility marketing strategies that engage stakeholders – particularly brokers, consultants and plan sponsors – with Humana’s products, services and strategies. Primary strategic activities includes: working with marketing leadership to assess the objectives of our business partners and developing accompanying research plans, and overseeing the development of marketing strategies that extend Humana’s Group Medicare brand among our key sales stakeholders. As the Senior Product Marketer, you will work closely with your leader, Group Medicare Marketing team members, and internal business partners to provide trusted counsel on marketing strategy, target audience development and activation strategies and annual planning. Key Role Functions Understand broker/consultant and plan sponsor perceptions and needs, and lead the development of strategic initiatives and tools to fulfill those needs while building the Humana Group Medicare and enterprise brand Create compelling and visually-appealing internal and external communications Own and drive the competitive intelligence and research strategy for Group Medicare business Support the development of marketing plans based on business partner objectives, including thought leadership Develop, execute, and manage integrated marketing communication plans across digital marketing channels Act as a liaison between internal partners and cross-functional marketing partners to develop and activate marketing plans and strategies in support of business priorities Ensure the team budget is appropriately tracked and reported each month Ensure marketing tactics are on-brand, consistent in voice and tonality, and optimized for search and user experience across channels including Humana owned, Social, SEM, Display, Email, Mobile, Video, offline, etc. Create and manage the planning cycle, deliverables, and annual calendar Deliver measurement strategies to accompany marketing activities and oversee to ensure execution; lead and manage effective reporting and related communications to the business Manage external resources and vendors; collaborate cross-functionally and throughout the organization To be successful in this role, you will need to be an action-oriented, self-starter with strong organizational skills, who is thorough and demonstrates a lot of initiative and follow-through. As a team player, you must be flexible, enthusiastic and demonstrate a willingness to learn. Use your skills to make an impact Required Qualifications Bachelor’s degree 5+ years of related marketing experience Marketing experience with a demonstrated ability of managing and prioritize a diverse set of projects A thorough understanding of business, marketing strategy, digital marketing, and product and content marketing Outstanding, demonstrated project management skills Strong, demonstrated skills developing successful finalist and other sales presentations Strong, demonstrated strategic skills and consulting skills Ability to influence, and collaborate in a cross-functional environment Excellent communication skills, written and verbal; able to communicate at all levels of an organization Preferred Qualifications Master’s Degree of Business Administration Experience with activating field-based marketing activities such as conferences or other events Some sales or sales support experience – including the development of value proposition messaging, marketing plans and open enrollment deliverables Prior marketing experience for a Fortune 500 company, healthcare Additional Information To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested Satellite, cellular and microwave connection can be used only if approved by leadership Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including: Health benefits effective day 1 Paid time off, holidays, volunteer time and jury duty pay Recognition pay 401(k) retirement savings plan with employer match Tuition assistance Scholarships for eligible dependents Parental and caregiver leave Employee charity matching program Network Resource Groups (NRGs) Career development opportunities Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $84,600 - $116,300 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
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    Become a part of our caring community and help us put health first You have the unique opportunity to join our newly established Integrated Health technology team and help enable seamless delivery of health and care services to the customer across their journey through the ecosystem. Integrated Health will continue to bring the CenterWell assets closer together leveraging patient experience initiatives as a core driver to developing cross-asset capabilities and leveraging data in new ways. If this type of work and vision resonates with you, we would like to talk to you! The Senior Release Train Engineer (RTE) has Comprehensive, end-to-end responsibility as facilitator and coach of a moderately complex Agile Release Train (ART). Ensures all events are aligned with Scaled Agile Framework (SAFe) methods in a way that adds both speed and value to product delivery. The Senior Release Train Engineer performs moderately complex to complex work necessitating independent initiative, judgement as well as a need to react quickly and adapt to changing department or team needs. The Senior Release Train Engineer work includes serving as the overall facilitator and coach of a moderately complex Agile Release Train (ART). This includes leveraging various Agile methodologies and Program Maturity, Assessments, Metrics, Dashboards to both coach and demonstrate to the teams how they best align around value delivery with the spirit of continuous improvement. Leverages feedback loops and ceremonies designed to identify and navigate the various challenges that are impeding the flow of work. Overall, the Senior Release Train Engineer encourages a culture of innovation by implementing SAFe and Agile practices and principles which include techniques to increase collaboration, predictability, transparency and velocity. Key Responsibilities: · Serves as the ART conductor, leading the appropriate use of SAFe principles, ceremonies and tools for a moderately complex program · Facilitates PI Planning and PI Planning readiness by fostering a Continuous Exploration process that drives the synthesis of a Vision, Roadmap, and Backlogs through Pre and Post-PI Planning events · Actively coaches, mentors and influences technical teams, scrum masters, and business partners in Lean-Agile practices and mindsets · Helps teams refine value streams · Coaches the teams to identify and remediate related dependencies/barriers including taking ownership of improvement items that come from the Inspect & Adapt and Problem-Solving Workshop events · Encourages collaboration between teams and System and Solution Architects and Engineering · Creates collaborative environments resulting in aligned decisions among program, technical and business teams · Orchestrates synchronized program level processes and executes across several scrum and product teams · Works with Product and Solution Management, Product Owners, and other stakeholders to help ensure strategy and execution alignment · Work with the Agility Enablement Hub on the overall program execution and operational excellence · Drives relentless improvement via Inspect and Adapt workshops; assess the agility level of the ART and helps them foster Communities of Practice and the use of engineering and Built-In Quality practices · Ensures teams maintain focus on quality and continuous delivery of business value while generating artifacts necessary to maintain cadence and synchronization on the train · Makes decisions on moderately complex issues exercising discretion and judgement over policies and practices. Works independently determining methods and approach to work. Determines priorities and timelines for own work. Required Qualifications: 5+ years related experience including 2+ on large scale, technically complex projects Experience working within the SAFe Framework as an IT Project Manager, scrum master, other related mentorship type role, or any equivalent combination of education, experience, and training that provides the required knowledge, skills, and abilities Knowledge of Agile/Scrum/Kanban development methodology Demonstrate execution through complex value streams Success in working across multiple teams of stakeholders including IT Teams, Business Teams, Product Managers, Product Owners and Portfolio Managers Excellent communication skills, mentorship/leadership competencies, expertise in operating through influence, and high level of emotional intelligence Must be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications: Bachelor’s degree in business, Information Technology or a related field Scaled Agile (SAFe) certification(s): RTE and/or Safe Program Consultant (SPC) Familiarity of one or more Agile Lifecycle Management Tools like Azure DevOps or JIRA Align Advanced Scrum Master certification like CSP-SM, A-CSM, or PSM III Prior experience in the health solutions industry Familiarity of the Software Development Lifecycle (SDLC) Use your skills to make an impact Work-At-Home Requirements WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense. A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required. Satellite and Wireless Internet service is NOT allowed for this role. A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $104,800 - $144,300 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
    • Full Time
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    Become a part of our caring community and help us put health first You have the unique opportunity to join our newly established Integrated Health technology team and help enable seamless delivery of health and care services to the customer across their journey through the ecosystem. Integrated Health will continue to bring the CenterWell assets closer together leveraging patient experience initiatives as a core driver to developing cross-asset capabilities and leveraging data in new ways. If this type of work and vision resonates with you, we would like to talk to you! The Senior IT Product Manager conceives, develops, delivers, and manages products for use across Humana. Oversees and manages all phases of the product lifecycle, from design conception to delivery. The Senior IT Product Manager work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior IT Product Manager works with relevant Humana stakeholders to create, prioritize, and manage product backlogs. Ensures final products meet IT and Humana standards and deliver maximum value to end-users. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. The Senior IT Product Manager plays a critical role in guiding our team evolving into an Agile Release Train (ART) and ensuring the successful delivery of products that meet customer needs. You will collaborate closely with cross-functional teams or teams working in a traditional way as needed, including development, QA, and operations, to drive product development from ideation to release. Key Responsibilities: · Product Vision and Strategy: Define and communicate the product vision and strategy aligned with the company’s goals. Ensure that all stakeholders are aligned and working towards common objectives. · Backlog Management: Prioritize and manage the product backlog, ensuring that the most valuable features are delivered to our customers. Collaborate with Product Owners to refine and maintain the backlog. · ART Leadership: Act as a key player in the Agile Release Train. Work regularly with the Release Train Engineer (RTE)/Program Manager and System Architect in steering the ART, preparing for and facilitating PI Planning sessions, and enabling seamless coordination across teams. · Feature Prioritization: Balance customer needs, technical feasibility, and business value to prioritize features and ensure timely delivery. Make data-driven decisions to guide product development. · Stakeholder Collaboration: Work closely with key stakeholders, including business owners and customers, to gather requirements and feedback. Ensure clear communication of product goals and progress. · Steer the ART: Work with Release Train Engineer/Program Manager and System Architect in steering the ART, addressing any impediments and ensuring that teams have the necessary resources and support. · Continuous Improvement: Promote a culture of continuous improvement within the teams. Facilitate retrospectives and encourage feedback to enhance product quality and team performance. Required Qualifications: Education: Bachelor’s degree or equivalent and relevant work experience. Experience: Minimum of 5 years of experience in product management, with at least 3 years in a SAFe environment. Proven track record of managing complex products and delivering successful outcomes. Agile Proficiency: Deep understanding of Agile methodologies and the SAFe. Experience with Agile Project Management Tools such ADO, Jira Align, or similar. Certifications: Certified SAFe Product Manager/Product Owner (SPM/POPM) or equivalent certification. · Technical Expertise: Strong technical background, with the ability to understand and discuss architectural concepts, trade-offs, and new opportunities with development teams. Communication Skills: Excellent communication and leadership skills, capable of influencing and motivating teams and stakeholders. Problem-Solving: Strong analytical and problem-solving skills, with the ability to navigate complex challenges and drive effective solutions. Customer Focus: Passion for delivering value to customers and ensuring that product development efforts prioritize customer needs and satisfaction. Use your skills to make an impact Work-At-Home Requirements WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense. A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required. Satellite and Wireless Internet service is NOT allowed for this role. A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $102,200 - $140,700 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
    • Full Time
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    Become a part of our caring community and help us put health first The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Creating Healthy Communities is good for the Soul. Join Us! The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, care or services for members. Coordinates and communicates with providers, members, or other parties to facilitate appropriate discharge planning including to assist with social determinants and closing gapsReview UM inpatient admission and clinical information to determine appropriate level of careUnderstands department, segment, and organizational strategy and operating objectives, including their linkages to related areas Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where neededFollows established guidelines/procedures ** Schedule and Hours are: Thursday and Friday 8:00am-7pm & Saturday and Sunday 6:00am-5pm (Days off are Monday, Tuesday & Wednesday) ** Use your skills to make an impact Required Qualifications Licensed Registered Nurse (RN) in KY, IN, MI, OH, WV or Compact license, with no disciplinary action3+ years of prior clinical experience preferably in an acute care hospital settingComprehensive knowledge of Microsoft Word, Outlook and ExcelExcellent communication skills both verbal and writtenAbility to work independently under general instructions and with a teamMust be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications Bachelor's degree in nursing (BSN)Health Plan experiencePrevious Medicare experience a plusUtilization Management experienceMilliman/MCG experience Work-At-Home Requirements To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggestedSatellite, cellular and microwave connection can be used only if approved by leadershipAssociates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expenseHumana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/jobWork from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Additional Information Schedule and Hours are: Thursday and Friday 8:00am-7pm & Saturday and Sunday 6:00am-5pm (Days off are Monday, Tuesday & Wednesday) Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $69,800 - $96,200 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
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    Become a part of our caring community and help us put health first Humana is seeking an Associate Director, Network Operations to support the Wisconsin Medicaid market. The Associate Director, Network Operations maintains provider network operations to support business activities through credentialing and provider data integrity management needed for service operations. This position requires a solid understanding of how organization capabilities interrelate across department(s). Humana’s Wisconsin Medicaid Associate Director, Network Operations manages credentialing and provider data functions for all lines of business including but not limited to demographics, rates, credentialing, network adequacy analysis and reporting, and contract documentation. This role manages the credentialing and provider data management processes and systems. The responsibilities for this role span 5 different lines of business for a total of 6 plans: Medicare DSNP (2 separate plans under this product), Medicaid SSI and Badger Care Plus, Family Care Partnership, and Family Care. Decisions are typically related to identifying and resolving complex technical and operational problems within department(s), and could lead multiple managers or highly specialized professional associates. Duties include but are not limited to: Manage and direct the activities of the leaders over three distinct areas respectively: Provider Data Management and Contract Load, Provider Credentialing, and Certification of 1-2 Bed Adult Family Homes, as well as several Business Support Coordinators who will support these activities.Manage continued compliance with NCQA requirements for the Medicaid lines of business with respect to credentialing and provider data management and reporting.Evaluate and make strategic decisions with respect to positioning the company to attain NCQA designation for the long-term care lines of business.Direct staff for at least the next 2 years working in totally different technology and operational systems.Accountable to direct day to day activities of staff, working with staff in a matrixed environment, making critical complex strategic and operational decisions, making recommendations to executives, and for the delivery of all work in a manner that is consistently compliant with ever changing laws and regulations that govern Medicare and Medicaid programs. Use your skills to make an impact Required Qualifications 7 or more years of progressive provider network or related experience for a government health plan.3 or more years of solid leadership/management experience or equivalent including supervisory and teambuilding.Experience working with regulatory requirements for government programs to ensure the highest level of data integrity, directory accuracy, adequacy, and regulatory reporting.Strong analytical acumen with proficiency in use of data and reporting and interpreting provider data.Knowledge of credentialing and provider data within Medicare and /or Medicaid lines of business. Preferred Qualifications Bachelor’s or master’s degree in business administration or finance.Knowledge of NCQA Health Plan and Health Equity Accreditation Standards.Prior work experience with Wisconsin Medicaid and Long-term care. Additional Information Workstyle: Home. Home workstyle is defined as remote but will use Humana office space on an as needed basis for collaboration and other face-to-face needs. Location: must reside within commutable distance to Wisconsin offices for occasional in-person meetings. Travel: requires occasional travel to Wisconsin for in person meetings. Typical Work days/hours: Monday – Friday, 8:00 am – 5:00 pm Central Standard Time (CST)Direct Reports: approximately 9 direct reports WAH Internet Requirements To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.Satellite, cellular and microwave connection can be used only if approved by leadership.Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Benefits Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including: Health benefits effective day 1Paid time off, holidays, volunteer time and jury duty payRecognition pay401(k) retirement savings plan with employer matchTuition assistanceScholarships for eligible dependentsParental and caregiver leaveEmployee charity matching programNetwork Resource Groups (NRGs)Career development opportunities HireVue As part of our hiring process for this opportunity, we will be using an interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. #LI-JP1 Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $93,000 - $128,000 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
    • Full Time
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    Become a part of our caring community and help us put health first EOE Business Intelligence is an Enterprise Operations Enablement team focused on data, reporting and data science supporting Humana’s Service Operations. The team is focused on converting data to actionable insights for our business partners who can utilize to reduce administrative cost and improve the customer’s experience. This position will work within the ESS Business Intelligence team. This team is focused on gathering and documenting data requirements for Data Science, Data Consulting, Data Visualization, and Reporting. Come join our Fortune #40, Best Places to Work company and help us make a difference as we help our members achieve their best health! The Senior Data Manager acquires, cleans, and develops datasets from internal and external sources to support business analysis and reporting. The individual will acquire, validate, store, protect, and adhere to processes around data to ensure the accessibility, reliability, and timeliness of the data for its users. The candidate will also be responsible for developing and executing data architectures, policies, practices, and procedures that properly manage the full data lifecycle needs of an enterprise. The ideal candidate will have: Ability to interact with business and IT departments in understanding user needsAble to translate the business needs to technical requirements in terms of data needsBe self-motivated and possess the ability to manage multiple priorities and meet deadlines.Possess the capacity to maintain confidentiality and work independently.Identifies opportunities for process improvementsCoordinates with other teams to ensure all aspects of data needs are taken into account.Coordination and completion of projects on time and within scopePrepare data for reporting and analysis including visualizations to support business requirements.Experience in performing in-depth data analysis to derive insights that drives business outcomes and decisions.Exhibit strong written and verbal communication skillsBe an innovative thinker with an innate curiosity around dataBe self-motivated and possess the ability to manage multiple priorities and meet deadlinesExperience in problem analysis and process documentation Use your skills to make an impact Required Qualifications Undergraduate degreeMinimum 5 years of technical experience in designing, developing, supporting, and implementing end-to-end data integration solutions using Azure Data Factory (ADF), SNOWPipe, Azure Synapse Analytics, and/or SNOWFLAKEExperience providing expert architecture guidance on Data Warehouse, Data Lake, and Modern BI architecture concepts and technologies using Azure Synapse Analytics and SNOWFLAKEExperience implementing scalable and maintainable Dimensional Data Models to meet business objectives, includes construction of Azure Data Factory and automation of data architecturesHealthcare or managed care experienceExperience taking complex data and making it more accessible, understandable and usable for leaders to derive insightsExperience working on a project through its entire life cycle, from design, coding, code review and deploymentProficient in root cause analysisDemonstrated ability to problem solve and provide solutions for business or data issuesAbility to work with clients, listen to their needs, and make suggestions on potential solutionsStrong presentation skills to conduct demonstration meetings with clients to show progress on projects Work-At-Home Requirements At minimum, a download speed of 25 mbps and an upload speed of 10 mbps is recommended; wireless, wired cable or DSL connection is suggestedSatellite, cellular and microwave connection can be used only if approved by leadershipAssociates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Preferred Qualifications Experience with migrating data to the cloud (Azure Data Lake) and/or Cloud based computing (MS Azure), SNOWFLAKEExperience with Data Warehousing (Azure/SQL/Synapse), ETL (Azure Data Factory/SSIS), Microsoft Power AppsCall Center and/or Salesforce CRM experience Additional Information As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called Modern Hire. Modern Hire Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you.If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. This is a remote role - #LI-Remote Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $95,300 - $131,200 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
    • Full Time
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    Become a part of our caring community and help us put health first The Utilization Management Nursing Professional contributes to team and enterprise goals as a team member. Will apply Utilization Management Nursing skills and experience to work on assignments that are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Post-Acute Utilization Management Nurse 2 (VSP): Review cases using clinical knowledge, communication skills, and independent critical thinking skills towards interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, care or services for members.Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment. Provider calls *** Variable Staffing Pool (VSP) are Associates who work flexible hours to meet business needs, with no guaranteed minimum or maximum number of hours in any week. (This position will likely work 40 hours per week) *** Use your skills to make an impact Required Qualifications Licensed Registered Nurse (RN) or Licensed Practical Nurse (LPN) in the appropriate state, with no disciplinary action2+ years of Post Acute clinical experience in a SNF, LTACH or Rehab settingComprehensive knowledge of Microsoft Word, Outlook and ExcelAbility to work independently under general instructions and with a teamMust be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications Bachelor's degree in nursing (BSN)Previous experience in Discharge Planning or Utilization ManagementExperience working with Milliman MCG or CMS guidelinesHealth Plan experiencePrevious Medicare/Medicaid Experience a plus Work-At-Home Requirements To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggestedSatellite, cellular and microwave connection can be used only if approved by leadershipAssociates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expenseHumana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/jobWork from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Additional Information Work Hours are - Monday-Friday 8am-5pm MST or PST, this position will likely work 40 hours per week. (Variable Staffing Pool (VSP) are Associates who work flexible hours to meet business needs, with no guaranteed minimum or maximum number of hours in any week)This is a remote position Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $69,800 - $96,200 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers benefits for limited term, variable schedule and per diem associates which are designed to support whole-person well-being. Among these benefits, Humana provides paid time off, 401(k) retirement savings plan, employee assistance program, business travel and accident. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
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    Become a part of our caring community and help us put health first The Lead Data Architect works in all data environments which includes data design, database architecture, metadata and repository creation. The Lead Data Architect works on problems of diverse scope and complexity ranging from moderate to substantial. The Lead Data Architect is accountable for interpreting the Service business goals and drivers and translating business strategies and objectives into a data product. The role will have shared accountability for assuring the quality of product strategy inputs and business requirements, functional design, and alignment to prioritized roadmap, in partnership with Product, Data Science, Reporting and IT team. This individual supports projects or change initiatives by providing insights and required ad hoc analytics. This individual acts as the primary owner for solutions across EOE driving and influencing. The individual evaluates the reusability of current data for separate analyses. This individual advises executives to develop functional strategies (often segment specific) on matters of significance. This individual exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision. This individual uses independent judgment requiring analysis of variable factors and determining the best course of action. Use your skills to make an impact Required Qualifications Bachelor’s degree in Computer Science, Information Technology, or related fieldSAFe Agile certificationMinimum 8 years of data analytics experienceExperience in using statistics, modeling, business analysis, and technology to transform high volumes of complex data into advanced analytic solutionsDemonstrated experience in working on problems of diverse scope and complexity ranging from moderate to substantialExperience working within the healthcare industry with an emphasis on insuranceExperience in developing, maintaining, and collecting structured and unstructured data sets for analysis and reportingExperience in creating reports, projections, and presentations to support businessAbility to exercise independent judgment and decision making on complex issues regarding job duties and related tasksKnowledge or experience working with customer-centric technologies (i.e. Genesys, Salesforce)Ability to works under minimal supervision, using independent judgmentMust be passionate about contributing to an organization focused on continuously improving consumer experiences Work-At-Home Requirements At minimum, a download speed of 25 mbps and an upload speed of 10 mbps is recommended; wireless, wired cable or DSL connection is suggestedSatellite, cellular and microwave connection can be used only if approved by leadershipAssociates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Preferred Qualifications Master’s DegreeExperience in large Enterprise environmentsFamiliarity with a data visualization solution such as Tableau or Power BIExposure to cloud data platforms: Snowflake, Azure, Event Driven Architecture Additional Information As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called Modern Hire. Modern Hire Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you.If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. This is a remote role - #LI-Remote Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $126,800 - $174,500 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
    • Full Time
    • 0
    • 0
    Become a part of our caring community and help us put health first The Pharmacy Contracting Executive ensures contract compliance and performs analysis regarding pharmacy claims and contracts to design, build, and maintain Humana's pharmacy networks The Pharmacy Contracting Executive ensures contract compliance and performs analysis regarding pharmacy claims and contracts to design, build, and maintain Humana's pharmacy networks. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks and collaborates with numerous teams across the organization regarding network setups. Uses independent judgment requiring analysis of variable factors and determining the best course of action and implementation ensuring accurate and reliable claims adjudication. Works alongside SS&C, Humana's claim processor, to test and advise on network design based on business need and contractual expectations. Creates and analyzes test cases and claims data to inform and recommend critical business decisions. Use your skills to make an impact Required Qualifications 5 or more years' experience in pharmacy setups including development, implementation, and maintenanceExtensive knowledge of pharmacy plans and how Humana's pharmacy network setups connect and interact with other areas across the organization (e.g., benefits, formulary, etc.)Proficiency with Microsoft Access and ExcelStrong financial acumen with proficiency in analyzing and interpreting dataAbility to manage multiple tasks and deadlines with attention to detailAbility to communicate effectively and deliver presentations to senior management and external business partnersAble to give direction and make sound business decisionsMust be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications Bachelor's Degree5 or more years' experience with pharmacy contracting and pricingFamiliarity with CMS' Plan Finder application and RxIntelProcess improvement experience Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $84,600 - $116,300 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
    • Full Time
    • 0
    • 0
    Become a part of our caring community and help us put health first Humana: A Fortune 60 Healthcare Company Humana is a publicly traded, Fortune 60 health benefits company with a long history of successful innovation and reinvention. It has transformed itself from the largest US nursing home company in the ’60s, to the largest US hospital corporation in the ’80s, to a leading health benefits company beginning in the ’90s. Today, Humana is a leader in consumer-focused health solutions and is one of the largest health benefits organizations in the country. The Enterprise Growth Strategy team is a newly created organization supporting growth across Humana’s businesses. The team has a strong dotted-line partnership with the Medicare and Medicaid organization, Humana’s largest, which comprises over 80% of the company’s total revenue and the majority of its earnings. Team members partner with senior leaders of the business unit, and more broadly with leaders throughout the enterprise, as they deliver strategy projects addressing some of the businesses’ most important opportunities and challenges. These high-profile strategy projects place the team at the forefront of helping to define the future of the organization. Humana is seeking an experienced team member to support delivering Enterprise Growth’s highest priority strategy projects and initiatives, with an emphasis on Medicare Advantage strategy development. As a Consultant, you will deconstruct issues and challenges, perform targeted research and analysis, and craft sound, logical solutions and recommendations. You will also shape implementation considerations, and work with business owners as appropriate to transition analysis into execution. While doing so, you will have the opportunity to collaborate with fellow team members, subject matter experts, members of Humana’s executive Management Team, and corporate, functional, and business unit leaders. Select project examples include (1) Optimization of Medicare enrollment growth strategy, such as balancing marketing, sales, and product investment trade-offs that are responsive to local competitive and provider dynamics; (2) Development of Medicare Product strategies that are aligned with the unique needs of Humana’s target growth segments Key responsibilities include: Conducting analysis and/or work streams within high-profile, high-impact strategy projects Participating in interviews and working sessions with leaders within Medicare and Medicaid and across the broader organization Conducting industry, market, competitor, and financial analysis and identifying insights for Humana Creating high quality analysis and deliverables that clearly frame objectives, issues, and challenges, and articulate insightful findings and recommendations Working collaboratively with fellow team members and leaders across the company Use your skills to make an impact Required Qualifications Bachelor’s Degree with outstanding academic credentials 2+ years of full-time work experience in strategy consulting, investment banking, corporate/business unit strategy, or finance, including a strong record of leadership Strong problem-solving skills and demonstrated ability to perform complex quantitative and qualitative analysis Excellent verbal and written communication abilities Ability to quickly build and maintain trust with business leaders Highly collaborative, flexible, teamwork-oriented working style Demonstrated ability to mentor and develop junior staff Strong commitment to personal and professional growth Preferred Qualifications Managed care and/or healthcare services work experience Additional Information Flexibility with work location; options include: Humana’s New York office in Midtown Manhattan Humana’s headquarters in Louisville, Kentucky Remote, with majority of work conducted on Eastern time Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $101,400 - $139,600 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About Us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
    • Full Time
    • 0
    • 0
    Become a part of our caring community and help us put health first Humana Healthy Horizons in Indiana is seeking a Care Coordinator 2 (Field Care Manager 2) who assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. This position serves members of the new Indiana Medicaid program - Indiana PathWays for Aging (PathWays). The program was designed to help more Hoosiers who choose to age at home, do so, and to achieve better access to services, and better health and quality outcomes. You will be part of a caring community at Humana. When you meet us, you can tell we started as a hometown company. We are proud of our Louisville roots and, as we have grown, that community feeling has spread across all 50 states and Puerto Rico. No matter where you are—whether you are working from home, from the field, from our offices, or from somewhere in between—you will feel welcome here. We are a caring community made of close-knit teams, cross-country friendships, and inclusive resource groups, all gathered around one big table where everyone’s voice is heard and respected. Community is a verb here. It is up to each of us to care for it and maintain it. Because the relationships we form will help us deliver better health outcomes for the people we so proudly serve. * Health Insurance begins on day one! * 23 days of vacation with pay per year * Aggressive 401K program matching 125% of 6% after year one! Are you caring, Curious and Committed? If so, apply today! Position Responsibilities: The Care Coordinator 2 employs a variety of strategies, approaches, and techniques to manage a member’s physical, environmental, and psycho-social health issues. Identifies and resolves barriers that hinder effective care. Facilitate the development of a longitudinal and trusting relationship with each member toward improved quality, continuity, and coordination of care.Responsible for the coordination of all the member’s needed medical and non-medical services, including functional, social, and environmental services.Works collaboratively with the Service Coordinator, Transition Coordinator, and other care team staff to address the member’s identified needsCoordinates with all Medicare payers, Medicare Advantage plans, and Medicare providers as appropriate to coordinate the care and benefits of members who are also eligible for Medicare.Primary point of contact for the Interdisciplinary Care Team (ICT) and shall be responsible for coordinating with the member, ICT participants, and outside resources to ensure the member’s needs are met. Use your skills to make an impact Required Qualifications Must reside in Indiana.Licensed Registered Nurse (RN) in the state of Indiana without restrictionsAt least one (1) year of experience in providing case management or similar health care servicesIntermediate to advanced computer skills and experience with Microsoft Word, Excel, and Outlook.Exceptional communication and interpersonal skills with the ability to build rapport with internal and external customers and stakeholders.Proven ability of critical thinking, organization, written and verbal communication and problem- solving skills.Ability to manage multiple or competing priorities in a fast-paced environment.Ability to use a variety of electronic information applications/software programs including electronic medical records. Preferred Qualifications Bilingual (English/Spanish) or (English/Burmese)Prior nursing home diversion or long-term care case management experiencePrior experience with Medicare & Medicaid recipientsExperience working with a geriatric populationExperience with health promotion, coaching and wellnessKnowledge of community health and social service agencies and additional community resources About Humana Your growth is what drives Humana forward. When you get here, the journey is just beginning. Our leaders are committed to understanding what you need to grow. Because we do not grow without youThis is a place where our nurses influence the C-suite.Where software engineers change lives.Where every associate can build a professional path where they learn and thrive.Through our commitments to wellbeing and work-life balance, we support each associate’s personal health, purpose, work style, sense of belonging, and security.Because finding new ways to put health first—for our members and patients and our associates alike—is what we do. Additional Requirements/Adherence Workstyle: Combination remote work at home and onsite member visits Location: Must reside in Indiana Hours: Must be able to work a 40-hour work week, Monday through Friday 8:00 AM to 5:00 PM, over-time may be requested to meet business needs. Travel: Must be willing to commute about 70% to meet with members. On Call-Telephonic on call for an occasional night and/or weekend may be required. Work at Home Guidance To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.Satellite, cellular and microwave connection can be used only if approved by leadership.Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Driver's License, Transportation, Insurance This role is a part of Humana's Driver Safety program and therefore requires and individual to have: Valid state driver's licenseProof of personal vehicle liability insurance with at least $100,000/$300,000/$100,000 limitsAccess to a reliable vehicle Tuberculosis (TB) screening program This role is considered patient facing and is part of Humana at Home's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB. Interview Format As part of our hiring process for this opportunity, we will be using an exciting screening and interviewing technology called Modern Hire to enhance our hiring and decision-making ability. We use this technology to gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. You will be able to respond to the recruiters preferred response method via text, video, or voice technologies. If you are selected for a screen, you may receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication is not missed) inviting you to participate. You should anticipate this screen to take about 15 to 30 minutes. Your recorded screen will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $69,800 - $96,200 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
    • Full Time
    • 0
    • 0
    Become a part of our caring community and help us put health first Humana Healthy Horizons in Indiana is seeking a Care Coordinator 2 (Field Care Manager 2) who assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. This position serves members of the new Indiana Medicaid program - Indiana PathWays for Aging (PathWays). The program was designed to help more Hoosiers who choose to age at home, do so, and to achieve better access to services, and better health and quality outcomes. You will be part of a caring community at Humana. When you meet us, you can tell we started as a hometown company. We are proud of our Louisville roots and, as we have grown, that community feeling has spread across all 50 states and Puerto Rico. No matter where you are—whether you are working from home, from the field, from our offices, or from somewhere in between—you will feel welcome here. We are a caring community made of close-knit teams, cross-country friendships, and inclusive resource groups, all gathered around one big table where everyone’s voice is heard and respected. Community is a verb here. It is up to each of us to care for it and maintain it. Because the relationships we form will help us deliver better health outcomes for the people we so proudly serve. * Health Insurance begins on day one! * 23 days of vacation with pay per year * Aggressive 401K program matching 125% of 6% after year one! Are you caring, Curious and Committed? If so, apply today! Position Responsibilities: The Care Coordinator 2 employs a variety of strategies, approaches, and techniques to manage a member’s physical, environmental, and psycho-social health issues. Identifies and resolves barriers that hinder effective care. Facilitate the development of a longitudinal and trusting relationship with each member toward improved quality, continuity, and coordination of care.Responsible for the coordination of all the member’s needed medical and non-medical services, including functional, social, and environmental services.Works collaboratively with the Service Coordinator, Transition Coordinator, and other care team staff to address the member’s identified needsCoordinates with all Medicare payers, Medicare Advantage plans, and Medicare providers as appropriate to coordinate the care and benefits of members who are also eligible for Medicare.Primary point of contact for the Interdisciplinary Care Team (ICT) and shall be responsible for coordinating with the member, ICT participants, and outside resources to ensure the member’s needs are met. Use your skills to make an impact Required Qualifications Perform job responsibility in Indiana.Licensed Registered Nurse (RN) in the state of Indiana without restrictionsAt least one (1) year of experience in providing case management or similar health care servicesIntermediate to advanced computer skills and experience with Microsoft Word, Excel, and Outlook.Exceptional communication and interpersonal skills with the ability to build rapport with internal and external customers and stakeholders.Proven ability of critical thinking, organization, written and verbal communication and problem- solving skills.Ability to manage multiple or competing priorities in a fast-paced environment.Ability to use a variety of electronic information applications/software programs including electronic medical records. Preferred Qualifications Bilingual (English/Spanish) or (English/Burmese)Prior nursing home diversion or long-term care case management experiencePrior experience with Medicare & Medicaid recipientsExperience working with a geriatric populationExperience with health promotion, coaching and wellnessKnowledge of community health and social service agencies and additional community resourcesLive/Reside in Indiana About Humana Your growth is what drives Humana forward. When you get here, the journey is just beginning. Our leaders are committed to understanding what you need to grow. Because we do not grow without youThis is a place where our nurses influence the C-suite.Where software engineers change lives.Where every associate can build a professional path where they learn and thrive.Through our commitments to wellbeing and work-life balance, we support each associate’s personal health, purpose, work style, sense of belonging, and security.Because finding new ways to put health first—for our members and patients and our associates alike—is what we do. Additional Requirements/Adherence Workstyle: Combination remote work at home and onsite member visits Location: Must reside in Indiana Hours: Must be able to work a 40-hour work week, Monday through Friday 8:00 AM to 5:00 PM, over-time may be requested to meet business needs. Travel: Must be willing to commute about 70% to meet with m:embers. On Call-Telephonic on call for an occasional night and/or weekend may be required. Work at Home Guidance To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.Satellite, cellular and microwave connection can be used only if approved by leadership.Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Driver's License, Transportation, Insurance This role is a part of Humana's Driver Safety program and therefore requires and individual to have: Valid state driver's licenseProof of personal vehicle liability insurance with at least $100,000/$300,000/$100,000 limitsAccess to a reliable vehicle Tuberculosis (TB) screening program This role is considered patient facing and is part of Humana at Home's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB. Interview Format As part of our hiring process for this opportunity, we will be using an exciting screening and interviewing technology called Modern Hire to enhance our hiring and decision-making ability. We use this technology to gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. You will be able to respond to the recruiters preferred response method via text, video, or voice technologies. If you are selected for a screen, you may receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication is not missed) inviting you to participate. You should anticipate this screen to take about 15 to 30 minutes. Your recorded screen will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $69,800 - $96,200 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
    • Full Time
    • 0
    • 0
    Become a part of our caring community and help us put health first Humana Healthy Horizons in Indiana is seeking a Care Coordinator 2 (Field Care Manager 2) who assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. This position serves members of the new Indiana Medicaid program - Indiana PathWays for Aging (PathWays). The program was designed to help more Hoosiers who choose to age at home, do so, and to achieve better access to services, and better health and quality outcomes. You will be part of a caring community at Humana. When you meet us, you can tell we started as a hometown company. We are proud of our Louisville roots and, as we have grown, that community feeling has spread across all 50 states and Puerto Rico. No matter where you are—whether you are working from home, from the field, from our offices, or from somewhere in between—you will feel welcome here. We are a caring community made of close-knit teams, cross-country friendships, and inclusive resource groups, all gathered around one big table where everyone’s voice is heard and respected. Community is a verb here. It is up to each of us to care for it and maintain it. Because the relationships we form will help us deliver better health outcomes for the people we so proudly serve. * Health Insurance begins on day one! * 23 days of vacation with pay per year * Aggressive 401K program matching 125% of 6% after year one! Are you caring, Curious and Committed? If so, apply today! Position Responsibilities: The Care Coordinator 2 employs a variety of strategies, approaches, and techniques to manage a member’s physical, environmental, and psycho-social health issues. Identifies and resolves barriers that hinder effective care. Facilitate the development of a longitudinal and trusting relationship with each member toward improved quality, continuity, and coordination of care.Responsible for the coordination of all the member’s needed medical and non-medical services, including functional, social, and environmental services.Works collaboratively with the Service Coordinator, Transition Coordinator, and other care team staff to address the member’s identified needsCoordinates with all Medicare payers, Medicare Advantage plans, and Medicare providers as appropriate to coordinate the care and benefits of members who are also eligible for Medicare.Primary point of contact for the Interdisciplinary Care Team (ICT) and shall be responsible for coordinating with the member, ICT participants, and outside resources to ensure the member’s needs are met. Use your skills to make an impact Required Qualifications Perform job responsibility in IndianaLicensed Registered Nurse (RN) in the state of Indiana without restrictionsAt least one (1) year of experience in providing case management or similar health care servicesIntermediate to advanced computer skills and experience with Microsoft Word, Excel, and Outlook.Exceptional communication and interpersonal skills with the ability to build rapport with internal and external customers and stakeholders.Proven ability of critical thinking, organization, written and verbal communication and problem- solving skills.Ability to manage multiple or competing priorities in a fast-paced environment.Ability to use a variety of electronic information applications/software programs including electronic medical records. Preferred Qualifications Bilingual (English/Spanish) or (English/Burmese)Prior nursing home diversion or long-term care case management experiencePrior experience with Medicare & Medicaid recipientsExperience working with a geriatric populationExperience with health promotion, coaching and wellnessKnowledge of community health and social service agencies and additional community resourcesLive/Reside in Indiana About Humana Your growth is what drives Humana forward. When you get here, the journey is just beginning. Our leaders are committed to understanding what you need to grow. Because we do not grow without youThis is a place where our nurses influence the C-suite.Where software engineers change lives.Where every associate can build a professional path where they learn and thrive.Through our commitments to wellbeing and work-life balance, we support each associate’s personal health, purpose, work style, sense of belonging, and security.Because finding new ways to put health first—for our members and patients and our associates alike—is what we do. Additional Requirements/Adherence Workstyle: Combination remote work at home and onsite member visits Location: Must reside in Indiana Hours: Must be able to work a 40-hour work week, Monday through Friday 8:00 AM to 5:00 PM, over-time may be requested to meet business needs. Travel: Must be willing to commute about 70% to meet with m:embers. On Call-Telephonic on call for an occasional night and/or weekend may be required. Work at Home Guidance To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.Satellite, cellular and microwave connection can be used only if approved by leadership.Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Driver's License, Transportation, Insurance This role is a part of Humana's Driver Safety program and therefore requires and individual to have: Valid state driver's licenseProof of personal vehicle liability insurance with at least $100,000/$300,000/$100,000 limitsAccess to a reliable vehicle Tuberculosis (TB) screening program This role is considered patient facing and is part of Humana at Home's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB. Interview Format As part of our hiring process for this opportunity, we will be using an exciting screening and interviewing technology called Modern Hire to enhance our hiring and decision-making ability. We use this technology to gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. You will be able to respond to the recruiters preferred response method via text, video, or voice technologies. If you are selected for a screen, you may receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication is not missed) inviting you to participate. You should anticipate this screen to take about 15 to 30 minutes. Your recorded screen will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $69,800 - $96,200 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
    • Full Time
    • 0
    • 0
    Become a part of our caring community and help us put health first Humana Healthy Horizons in Indiana is seeking a Care Coordinator 2 (Field Care Manager 2) who assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. This position serves members of the new Indiana Medicaid program - Indiana PathWays for Aging (PathWays). The program was designed to help more Hoosiers who choose to age at home, do so, and to achieve better access to services, and better health and quality outcomes. You will be part of a caring community at Humana. When you meet us, you can tell we started as a hometown company. We are proud of our Louisville roots and, as we have grown, that community feeling has spread across all 50 states and Puerto Rico. No matter where you are—whether you are working from home, from the field, from our offices, or from somewhere in between—you will feel welcome here. We are a caring community made of close-knit teams, cross-country friendships, and inclusive resource groups, all gathered around one big table where everyone’s voice is heard and respected. Community is a verb here. It is up to each of us to care for it and maintain it. Because the relationships we form will help us deliver better health outcomes for the people we so proudly serve. * Health Insurance begins on day one! * 23 days of vacation with pay per year * Aggressive 401K program matching 125% of 6% after year one! Are you caring, Curious and Committed? If so, apply today! Position Responsibilities: The Care Coordinator 2 employs a variety of strategies, approaches, and techniques to manage a member’s physical, environmental, and psycho-social health issues. Identifies and resolves barriers that hinder effective care. Facilitate the development of a longitudinal and trusting relationship with each member toward improved quality, continuity, and coordination of care.Responsible for the coordination of all the member’s needed medical and non-medical services, including functional, social, and environmental services.Works collaboratively with the Service Coordinator, Transition Coordinator, and other care team staff to address the member’s identified needsCoordinates with all Medicare payers, Medicare Advantage plans, and Medicare providers as appropriate to coordinate the care and benefits of members who are also eligible for Medicare.Primary point of contact for the Interdisciplinary Care Team (ICT) and shall be responsible for coordinating with the member, ICT participants, and outside resources to ensure the member’s needs are met. Use your skills to make an impact Required Qualifications Must reside in Indiana.Licensed Registered Nurse (RN) in the state of Indiana without restrictionsAt least one (1) year of experience in providing case management or similar health care servicesIntermediate to advanced computer skills and experience with Microsoft Word, Excel, and Outlook.Exceptional communication and interpersonal skills with the ability to build rapport with internal and external customers and stakeholders.Proven ability of critical thinking, organization, written and verbal communication and problem- solving skills.Ability to manage multiple or competing priorities in a fast-paced environment.Ability to use a variety of electronic information applications/software programs including electronic medical records. Preferred Qualifications Bilingual (English/Spanish) or (English/Burmese)Prior nursing home diversion or long-term care case management experiencePrior experience with Medicare & Medicaid recipientsExperience working with a geriatric populationExperience with health promotion, coaching and wellnessKnowledge of community health and social service agencies and additional community resources About Humana Your growth is what drives Humana forward. When you get here, the journey is just beginning. Our leaders are committed to understanding what you need to grow. Because we do not grow without youThis is a place where our nurses influence the C-suite.Where software engineers change lives.Where every associate can build a professional path where they learn and thrive.Through our commitments to wellbeing and work-life balance, we support each associate’s personal health, purpose, work style, sense of belonging, and security.Because finding new ways to put health first—for our members and patients and our associates alike—is what we do. Additional Requirements/Adherence Workstyle: Combination remote work at home and onsite member visits Location: Must reside in Indiana Hours: Must be able to work a 40-hour work week, Monday through Friday 8:00 AM to 5:00 PM, over-time may be requested to meet business needs. Travel: Must be willing to commute about 70% to meet with members. On Call-Telephonic on call for an occasional night and/or weekend may be required. Work at Home Guidance To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.Satellite, cellular and microwave connection can be used only if approved by leadership.Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Driver's License, Transportation, Insurance This role is a part of Humana's Driver Safety program and therefore requires and individual to have: Valid state driver's licenseProof of personal vehicle liability insurance with at least $100,000/$300,000/$100,000 limitsAccess to a reliable vehicle Tuberculosis (TB) screening program This role is considered patient facing and is part of Humana at Home's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB. Interview Format As part of our hiring process for this opportunity, we will be using an exciting screening and interviewing technology called Modern Hire to enhance our hiring and decision-making ability. We use this technology to gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. You will be able to respond to the recruiters preferred response method via text, video, or voice technologies. If you are selected for a screen, you may receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication is not missed) inviting you to participate. You should anticipate this screen to take about 15 to 30 minutes. Your recorded screen will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $69,800 - $96,200 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
    • Full Time
    • 0
    • 0
    Become a part of our caring community and help us put health first Humana Healthy Horizons in Indiana is seeking a Care Coordinator 2 (Field Care Manager 2) who assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. This position serves members of the new Indiana Medicaid program - Indiana PathWays for Aging (PathWays). The program was designed to help more Hoosiers who choose to age at home, do so, and to achieve better access to services, and better health and quality outcomes. You will be part of a caring community at Humana. When you meet us, you can tell we started as a hometown company. We are proud of our Louisville roots and, as we have grown, that community feeling has spread across all 50 states and Puerto Rico. No matter where you are—whether you are working from home, from the field, from our offices, or from somewhere in between—you will feel welcome here. We are a caring community made of close-knit teams, cross-country friendships, and inclusive resource groups, all gathered around one big table where everyone’s voice is heard and respected. Community is a verb here. It is up to each of us to care for it and maintain it. Because the relationships we form will help us deliver better health outcomes for the people we so proudly serve. * Health Insurance begins on day one! * 23 days of vacation with pay per year * Aggressive 401K program matching 125% of 6% after year one! Are you caring, Curious and Committed? If so, apply today! Position Responsibilities: The Care Coordinator 2 employs a variety of strategies, approaches, and techniques to manage a member’s physical, environmental, and psycho-social health issues. Identifies and resolves barriers that hinder effective care. Facilitate the development of a longitudinal and trusting relationship with each member toward improved quality, continuity, and coordination of care.Responsible for the coordination of all the member’s needed medical and non-medical services, including functional, social, and environmental services.Works collaboratively with the Service Coordinator, Transition Coordinator, and other care team staff to address the member’s identified needsCoordinates with all Medicare payers, Medicare Advantage plans, and Medicare providers as appropriate to coordinate the care and benefits of members who are also eligible for Medicare.Primary point of contact for the Interdisciplinary Care Team (ICT) and shall be responsible for coordinating with the member, ICT participants, and outside resources to ensure the member’s needs are met. Use your skills to make an impact Required Qualifications Must reside in Indiana.Licensed Registered Nurse (RN) in the state of Indiana without restrictionsAt least one (1) year of experience in providing case management or similar health care servicesIntermediate to advanced computer skills and experience with Microsoft Word, Excel, and Outlook.Exceptional communication and interpersonal skills with the ability to build rapport with internal and external customers and stakeholders.Proven ability of critical thinking, organization, written and verbal communication and problem- solving skills.Ability to manage multiple or competing priorities in a fast-paced environment.Ability to use a variety of electronic information applications/software programs including electronic medical records. Preferred Qualifications Bilingual (English/Spanish) or (English/Burmese)Prior nursing home diversion or long-term care case management experiencePrior experience with Medicare & Medicaid recipientsExperience working with a geriatric populationExperience with health promotion, coaching and wellnessKnowledge of community health and social service agencies and additional community resources About Humana Your growth is what drives Humana forward. When you get here, the journey is just beginning. Our leaders are committed to understanding what you need to grow. Because we do not grow without youThis is a place where our nurses influence the C-suite.Where software engineers change lives.Where every associate can build a professional path where they learn and thrive.Through our commitments to wellbeing and work-life balance, we support each associate’s personal health, purpose, work style, sense of belonging, and security.Because finding new ways to put health first—for our members and patients and our associates alike—is what we do. Additional Requirements/Adherence Workstyle: Combination remote work at home and onsite member visits Location: Must reside in Indiana Hours: Must be able to work a 40-hour work week, Monday through Friday 8:00 AM to 5:00 PM, over-time may be requested to meet business needs. Travel: Must be willing to commute about 70% to meet with members. On Call-Telephonic on call for an occasional night and/or weekend may be required. Work at Home Guidance To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.Satellite, cellular and microwave connection can be used only if approved by leadership.Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Driver's License, Transportation, Insurance This role is a part of Humana's Driver Safety program and therefore requires and individual to have: Valid state driver's licenseProof of personal vehicle liability insurance with at least $100,000/$300,000/$100,000 limitsAccess to a reliable vehicle Tuberculosis (TB) screening program This role is considered patient facing and is part of Humana at Home's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB. Interview Format As part of our hiring process for this opportunity, we will be using an exciting screening and interviewing technology called Modern Hire to enhance our hiring and decision-making ability. We use this technology to gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. You will be able to respond to the recruiters preferred response method via text, video, or voice technologies. If you are selected for a screen, you may receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication is not missed) inviting you to participate. You should anticipate this screen to take about 15 to 30 minutes. Your recorded screen will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $69,800 - $96,200 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
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